Viticchi Giovanna, Falsetti Lorenzo, Salvemini Sergio, Bartolini Marco, Ranghino Andrea, Buratti Laura, Silvestrini Mauro
Neurological Clinic, Marche Polytechnic University, Via Conca 1, 60020, Ancona, Italy.
Internal and Subintesive Medicine, Ospedali Riuniti Ancona, Ancona, Italy.
Acta Neurol Belg. 2022 Feb;122(1):83-90. doi: 10.1007/s13760-021-01637-x. Epub 2021 Mar 9.
Headache is considered as a possible complication of dialytic treatment in chronic kidney disease (CKD). The aim of this study was to evaluate possible change in headache characteristics after kidney transplantation in patients with CKD. During a 1-year period, we enrolled 110 subjects submitted to a kidney transplant in the previous 5 years. Headache characteristics before and after the transplant were investigated by a specific questionnaire. Possible effects of pharmacological therapies were also evaluated. 65.5% of patients complained of headache before the transplant (38.2% migraine and 14.5% dialysis headache). After transplant, 53.6% of patients reported changes in headache characteristics. In particular, 27.3% of the patients had a complete resolution, 19.1% presented a headache improvement and 7.2% showed a worsening. In both migraine and dialysis headache subgroups, steroids, beta-blockers and calcium channel blockers were associated with a significant improvement of headache. Kidney transplantation seems to impact significantly headache frequency and severity in patients with CKD. A careful evaluation and use of targeted treatments could improve both patients' compliance to therapies and quality of life.
头痛被认为是慢性肾脏病（CKD）透析治疗的一种可能并发症。本研究的目的是评估CKD患者肾移植后头痛特征的可能变化。在1年的时间里，我们纳入了110名在过去5年内接受肾移植的受试者。通过一份特定问卷调查移植前后的头痛特征。还评估了药物治疗的可能效果。65.5%的患者在移植前抱怨有头痛（38.2%为偏头痛，14.5%为透析性头痛）。移植后，53.6%的患者报告头痛特征有变化。特别是，27.3%的患者头痛完全缓解，19.1%的患者头痛有所改善，7.2%的患者头痛恶化。在偏头痛和透析性头痛亚组中，类固醇、β受体阻滞剂和钙通道阻滞剂与头痛的显著改善相关。肾移植似乎对CKD患者的头痛频率和严重程度有显著影响。仔细评估并使用针对性治疗可以提高患者对治疗的依从性和生活质量。
